Negotiated reimbursement rates for D3920 across 47 states, sourced from CMS Transparency in Coverage data. 471 rate records.
Hemisection (Not Root Canal/Restoration) (avg $290) is a surgical procedure that involves the removal of a portion of a multi-rooted tooth, typically due to severe periodontal disease or fracture. Clinical indications include significant bone loss or infection that compromises the tooth's integrity. Documentation must include a thorough clinical examination, radiographic evidence, and a detailed account of the surgical procedure. Reimbursement for hemisection can vary significantly by payor and state, with some insurers covering it as a surgical procedure while others may classify it differently, impacting the reimbursement amount.
Reimbursement rates for D3920 vary significantly by state, payor, and provider network. The national average negotiated rate is $290. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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| State | Avg Rate |
|---|---|
| New Hampshire | $399 |
| Florida | $370 |
| Pennsylvania | $362 |
| Connecticut | $346 |
| Nevada | $337 |
| State | Avg Rate |
|---|---|
| Wyoming | $173 |
| Tennessee | $160 |
| Nebraska | $144 |
| Iowa | $140 |
| West Virginia | $139 |